Title: Perioperative Difficulties in Previous Caesarean Section and Their On Table Management
Authors: Dr Paribhashita Mishra, Dr Rajkishori Dandotiya
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.117
Abstract
Introduction: Incidence of caesarean section is 30% of all surgeries. In recent times a woman with history of prior caesarean section becomes the most common indication of a repeat caesarean section especially when short interpregnancy interval is present.
Materials and Methods: It is an Prospective observational study done at Kamla Raja Hospital, Gajara Raja Medical College ,Gwalior from 2017 to2018 with the aim to study the perioperative difficulties in repeat caesarean section and manage them intraoperatively .Four hundred women with one or more caesarean section irrespective of age or parity were included.
Results: Maximum numbers of cases was between 20-29 years (91.25%).Out of 300 cases lower segment incision was given in 280 cases (70%). In 175(43.75%) cases there was difficulty in entering into abdominal cavity to reach the lower uterine segment due to various types of adhesions present between uterus and surrounding structures.
Discussion: Maximum complications were seen in age 20-29 and commonest complication being adhesions (37.5%), followed by scar dehiscence (14%), placenta praevia (3%), bladder injury (8%), adherent placenta praevia (1%) and casarean hysterectomy (0.5%).
Conclusion: Cases of caesarean section need to be educated about requirement of antenatal care, contraception, mode of delivery and timely referrals to tertiary centers.
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